With electronic medical records, physicians and hospital leaders have access to reams of data, much more so than in the past -- even too much, in some cases. Turning that data into actionable change can be challenging, but with the right approach, EMR data can be used to increase referrals to hospitals, imaging centers, standalone clinics and even individual specialists.
Typically, those who receive the most referrals belong to health systems or networks that partner with a vendor, one that sifts through the data and identifies opportunities for both financial and clinical improvement. There are a lot of vendors in the space, from Compulink and MediTouch to CureMD and Azalea Health, each with their strengths and weaknesses.
Lori Brenner, vice president of Georgia-based Tea Leaves Health, said an increasingly popular trend is to use electronic information to identify patients who are good candidates for referrals, as it not only addresses those patients' health needs but also increases collections for the specialists and medical centers in their geographic vicinity.
Tea Leaves' own efforts recently targeted women who were overdue for a mammogram, looking at certain demographic factors such as age, county, zip code, and when they last had an appointment. The key, said Brenner, is to identify individuals, not groups.
"A lot of solutions will look at what are called cohorts," she said, "and assume everyone in the cohort behaves the same way. But we know healthcare is individual. There are a lot of variables that affect it."
And how. The company's proprietary software contains a database of about 600 data variables, identifying things not readily gleaned from a typical EMR, such as nonsmokers, patients who self-report for joint pain, people who are on glucose monitoring strips, etc.
From there, very specific groups of people can be identified -- men aged 45-65 who self-report for joint pain, for example. Send them invitations to classes and seminars, said Brenner, and you get them thinking about ways to address their ailments. And perhaps convert them into patients.
The approach underscores the idea that, in the modern healthcare environment, data is king. Knowing what to do with that data can turn it into powerful information.
"We can find patients who may have self-reported for joint pain, overlay them on a map, find the centers who overlap with those consumers, and then find what organization that center is part of, and how to refer them there," said Brenner. "We can go back and look at which PCP used the imaging centers … (and) if it's a standalone they're using, if there's any way we can steer those referrals into the hospital's imaging center."
It helps to have both the consumer and the physician in mind. Recently, a Tea Leaves team did work on behalf of a health system reaching out to people who had self-reported joint pain; the team then went out and provided educational materials to relevant, nearby physicians, trying to create appropriate matches between both groups. The team members then went back and documented the conversations they had.
The financial result? A 2,000 to 1 return on investment for the hiring health system.
By targeting both the consumer and the physician, Brenner said it's possible to create matches that are beneficial to both.
"Physicians like to have that one-on-one relationship," she said. "It's proven to be the most effective way to increase physician referrals."